Kristen Hagler
BS, RVT, VTS (Physical Rehabilitation), CCRP, CVPP, OAM, VCC
Kristen has been an RVT since 2002 and has multiple credentials related to physical rehabilitation and pain management. In 2012, Kristen helped form the Organizing Committee of the Academy of Physical Rehabilitation Veterinary Technicians and was recognized as a Veterinary Technician Specialty in Physical Rehabilitation in 2017. In 2018, Kristen was awarded the California Veterinary Technician of the Year award by the California Veterinary Technician Association. Her special interests include veterinary orthotics and prosthetics, geriatrics, sporting and performance, mobility and service dogs, and multidisciplinary pain management strategies.
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I have never been happier to be constantly interrupted during a lecture. Well, interrupted may not be the right word. As I progressed through my points on various rehabilitation therapies, an interpreter relayed the message for a group of Japanese veterinary professionals, and I smiled as I watched the subject matter click in real time. While teaching abroad may move more slowly than a traditional lecture, it is fulfilling to tackle the challenge of making concise points and emphasizing visual learning devices.
And as I overcame the language barrier to share my common passion with this group, I couldn’t help but think back on my path. I never set out with a plan to teach overseas—in fact, I never intended to become an educator at all.
A Natural Progression
Professional development is often an ambiguous undertaking, especially in the early stages of a career. Formal education provides the backbone of a selected course of study, and day-to-day work experiences shape and pave the way for specialized interests over time. I remember early in my career enjoying the regular tones of monitoring equipment in the surgical suite, providing nursing care to recovering patients, and enjoying the ability to solely focus on job tasks without too many interjections. Interactions with people were limited to examination room intakes, brief discharge appointments, and peer training in the practice. Occasionally, colleagues expressed admiration for my ability to effectively communicate a new concept to a peer or pet parent, but I brushed compliments aside because “public speaking and teaching has never been my strong suit, and I could never do that.” To me, I was simply just doing the job at hand.
Patient care and recovery from orthopedic procedures have always been important to me, and I developed a special interest in orthopedics and physical rehabilitation over time. This led to further education and training in various specialized areas to hone my knowledge and skills. My personal thirst for information to help patients was fulfilled, but I never imagined how important it would be for me to communicate this knowledge to others.
Successful management of orthopedic, neurological, or surgical conditions relies heavily on pet parent education. As I explained all of the necessary information, some pet owners wanted to know more about disease pathology, others wanted to know more about the surgical procedure, and all were needing guidance on how to manage their pet’s mobility and pain management at home in a safe manner. Each discussion was unique and tailored to the pet, the household, and the family. I needed to be prepared to answer difficult questions with appropriate answers during these appointments to avoid disruptions in the veterinarian’s schedule. Some appointments required physical demonstration of a procedure needing to be done in the home while others utilized visual or audio aides, which propagated the development of learning tools out of necessity, driving development of skills on my part necessary for teaching a variety of learning styles. Without even realizing it, I was becoming an educator.
Examination room conversations with pet owners transitioned into speaking engagements at multiple national conferences and writing for publications such as the one you are reading. Professional connections grew with each seminar and eventually it happened—I was asked to travel internationally. Once again, the little voice spoke up saying this was something that would never happen. How could I be the one chosen to do this? I’m just doing my job.
Just Doing My Job
Making the decision to leave the country to teach was intimidating with limited experience traveling outside of the United States. In addition, my students would not speak or write a language that even resembled English. After much deliberation and reminding myself that it wasn’t the subject matter influencing a decision, I accepted the offer to teach veterinary nurses in Japan about physical rehabilitation. The biggest factor in making this decision was not letting personal fears get in the way of providing an exceptional course for colleagues hungry for knowledge. Instead, I looked at the invitation as an opportunity for professional growth and experiencing something I would never choose to do on my own.
Development of a multi-day curriculum course was already a familiar task, but this included the twist of ensuring the curriculum could be appropriately interpreted, translated, and completed in a timely manner. When providing a course in a foreign language, instructors must speak briefly then pause for the interpreter (usually a veterinarian) to translate the concept being delivered. Information is conveyed precisely and succinctly to avoid confusion while maintaining continuity of the session topic. In a specialty relying heavily on active movements during therapeutic exercise to encourage joint motion, there is always a lot of creativity trying to convey concepts to pet owners. If anyone has participated in a lecture from a rehabilitation provider, videos and images are frequently utilized for demonstrating concepts across languages or learning obstacles.

The author (top center) expanded her teaching skills by creating a well-rounded curriculum that resonated with a foreign audience.
I found myself finding imagery in its simplest form that spoke for itself in conveying a concept. For example, aquatic therapy has many therapeutic properties. Among its many properties, surface tension and cohesion could accurately be described by using imagery of a water strider bug standing on the surface, demonstrating how the cohesiveness of water allows an object to remain above the surface. This 3-pronged approach to learning with verbal, visual, and written content allowed students the opportunity to grasp concepts sooner despite language differences.
Be the Change
Traveling to a country with differences in culture, access to equipment, and educational programs was wonderfully enlightening. Official licensing and formal education for veterinary nurses/technicians in Japan are in the early stages of development; being able to explain the process of education and professional development in the United States from where it started with the first graduating class of credentialed veterinary technicians to the development of Veterinary Technician Specialties under the guidance of the National Association of Veterinary Technicians in America was a proud moment. The second moment was realizing that the seminar attendees included all female delegates who received special permission from employers to attend the learning program hosted by Improve International, the world’s largest continuing education provider. Delegates came from hospitals that are considered progressive and on the forefront of medicine in Japan, with employers being ahead of the curve in understanding the value veterinary nurses provide in successful patient care.
A 2010 study in the Journal of the American Veterinary Medical Association looked at whether a relationship existed between veterinary practice revenue and characteristics of veterinary technicians, including education level and qualifications. Results showed that the typical veterinarian’s gross income increased by $93 311 for each additional credentialed veterinary technician per veterinarian in the practice,1 directly attributing a value to an increased level of formal training and education when compared to non–traditionally educated support personnel. Career and professional development pathways for veterinary nurses and technicians in a variety of clinical and practical settings were unfamiliar to the Japanese and, as I am told, they were deeply inspired. Before the course, delegates had very little knowledge of the various career pathway opportunities, especially for women. With each question asked, I could sense new connections being made and a quiet agreement to move the profession forward and become the first official group of veterinary nurses in Japan. While this movement is several years away from becoming a reality, these women and their employers are looking forward to the future and accessibility of treatments for their patients.
An Ocean Away, Animals are the Same
Sometimes when we travel to unfamiliar places assumptions are made about standards of care or therapies available solely because of a lack of understanding. As previously mentioned, traveling overseas was new to me and I had no previous experience working in another country while following their cultural practices. Fortunately, a delegate working for one of the region’s renowned veterinary hospitals, WORLD Animal Hospital (world-ah.com), was able to obtain permission from the owner to have a foreign visitor tour the facility. We both shared a passion for rehabilitation therapy and team management, and upon entering the veterinary hospital, after replacing street shoes with slippers, I found myself right at home. Language barriers did not exist, treatment plans were the same, surgical suites were prepared in the same manner, and nearly all specialties were represented. As I toured the various departments, I was really struck with the effort made by the owners to promote self-care of the team. A rooftop location overlooking the city was set up for barbeques in the summer, a learning lounge filled with textbooks was available for the team, and an indoor meditation center was set up in a serene corner. While we joked about being too busy to use the relaxation time most days, I could tell there was a high level of respect and appreciation for all team members as each detail in the hospital was translated to me. We then explored the newly built rehabilitation center, which was adorned with giant white orchids in the lobby, a gift of congratulations.
While there, we spent a good hour carefully reviewing cases, troubleshooting therapeutic plans, and analyzing patient idiosyncrasies, all while watching beloved videos of the patients she was working with. The attention to detail and plan of care was incredible, which reminded me of the other delegates and their careful questions and desire to really learn what was being taught to them. All we needed was passion and a commonality.
We had only known each other for 2 days, but it felt like we had worked together for years because of our education, experience, and commitment to advancement in the field. Despite being an ocean away, the passion of a veterinary nurse in the field is the same. Taking risk is a part of our job as veterinary nurses and if I chose to take the conservative route, I would not be “just doing my job.” Challenge your fears, take risks, and enjoy the journey—it might lead you to some incredible places.
References
1. Fanning J, Shepherd AJ. Contribution of veterinary technicians to veterinary business revenue, 2007. JAVMA 2010;236(8):846.